How To Treat Head Lice

When you find lice on your child’s head, you have two problems to address:

  • Lice (the little bugs)
  • Nits (tiny cases attached to the hair, containing eggs which will hatch into baby lice)

You can address these problems:

  • Mechanically (by combing & picking bugs and nits out of the hair)
  • With topical solutions (treatments applied to the scalp to kill lice)
  • Using both a topical treatment and a comb

The third option (first treating to kill lice, and then combing out the nits) is the fastest and most thorough approach.

Removing Nits and Lice

The bare-bones method for how to treat head lice is simply to remove all lice and nits through very careful combing of the hair with a good lice comb. I have a friend who did it this way, with no special topical treatments at all.

I think this approach to how to treat head lice is most likely to succeed if the hair you’re dealing with is very short. We cut my son’s hair so short we could see his scalp and everything on the hair shaft pretty easily – so there was nowhere for the lice to hide, and nits were easy to see on close examination.

If you take this approach with longer hair, be aware that the combing is very labor-intensive and time-consuming. The most important thing to remember about how to treat head lice is that you must remove every single louse … and every single nit!

If you miss just one of those almost-invisible little nits, you will have a bug on your head in a week or so. If you miss just two of them, you may have a whole colony in a few weeks!

Using a regular hair conditioner applied to wet hair can make the comb slide through the hair more easily. This is very helpful for removing nits.

You must use an effective lice comb. This is the most important factor in how to treat head lice. There are many combs specifically for this purpose on the market, but some of them just won’t do the job.

Choose a comb that has metal teeth which are extremely close together. The only comb that worked on my daughter’s hair had teeth so close together you couldn’t see between them. (She has extremely fine hair.)

Head Lice Treatments

Topical treatments for head lice are designed to do some or all of the following:

  • Kill lice
  • Injure/slow down the lice (making them much easier to spot and comb out)
  • Dissolve/loosen the glue that holds the nits onto the hair shaft
  • Make the eggs unviable (dead or unable to hatch)

Products which injure or kill active lice are very helpful in removing the creatures – because normally lice can crawl very quickly away from a nit comb. They hide in the roots of the hair. You have to spot them and catch them to comb them out!

Dissolving or loosening nit glue can also make the comb-out process much easier. Nit glue is really strong and attaches very securely to the hair shaft. That’s why nits don’t come out with regular shampooing, combing and brushing.

Regardless of what the treatment you use claims to do, it’s really important to thoroughly nit-comb the hair after treating it. If you miss just a couple of nits, the eggs inside can hatch 7-10 days later and start the whole infestation cycle again.

The enzyme lice shampoo that worked so well for our family really loosened the nit glue. A lot of nits just fell out of my daughter’s hair as I ran a regular comb through it. The few nits remaining came out pretty easily with the nit comb.

“No-Comb” Treatments

A very few treatments claim that they will kill all the lice AND all the eggs, so that you can rid yourself of lice with no combing. You might still have nits attached your hair, but they would not have live eggs in them, and you could ignore them or get them out at your leisure.

This sounds very appealing because nit-combing properly takes a long time—and because it would be easy to miss two nits. Just two nits overlooked, and you might need to start all over again within weeks.

So it would be great to kill the eggs too. But nit shells are extremely tough. And the product would need to be 100% effective (killing every single egg) for you to rely on it. I haven’t seen evidence that ANY product can be relied upon to that extent.

However,some treatments do indeed kill eggs. Lousebuster treatments (available only from professional providers) and Licefreee spray (available at Amazon and your local drugstore) both kill eggs in their nits right along with the active lice.

You wouldn't want to rely on all the eggs being killed ... you'd need to follow up with careful monitoring, and it's best to comb out the nits to be dead certain they can't hatch. But that no-comb treatment is getting closer. :-)

It would be great to have several good options for how to treat head lice reliably without follow-up nit combing. (Many kids dislike sitting still for nit-combing.) So I’m always on the lookout for more no-comb treatments that work. Please let me know if you find any!


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Head lice can be removed safely and successfully. Just stay calm, follow through, make sure all lice and viable nits are gone.